Nokea
The clinic nurse is reviewing self-care management of acne vulgaris with an adolescent client. Which client statement indicates a need for further instruction?
- A. I have been scrubbing my face twice daily with antibacterial soap.
- B. I should buy skin care products that are labeled noncomedogenic.
- C. Maintaining a nutritious diet will help my skin heal.
- D. Picking or squeezing the lesions will worsen my acne.
Correct Answer: A
Rationale: Scrubbing with antibacterial soap can irritate skin and worsen acne. Noncomedogenic products, a nutritious diet, and avoiding picking are correct practices.
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A mother telephones the clinic and says 'I am worried because my breast-fed 1 month-old infant has soft, yellow stools after each feeding.' The nurse's best response would be which of these?
- A. This type of stool is normal for breast fed infants. Keep doing as you have.'
- B. The stool should have turned to light brown by now. We need to test the stool.'
- C. Formula supplements might need to be added to increase the bulk of the stools.'
- D. Water should be offered several times each day in addition to the breast feeding.'
Correct Answer: A
Rationale: In breast-fed infants, stools are frequent and yellow to golden, and vary from soft to thick liquid in consistency. No change in feedings is indicated.
The nurse has just received report on 4 clients. Which of the following reported information is the most concerning?
- A. Client on a heparin drip with an activated PTT of 60 seconds
- B. Client reporting back pain 1 hour following coronary angiography
- C. Client with a head injury and a Glasgow Coma Scale score of 14
- D. Client with incisional pain rated as 6 on a scale of 0-10, two days after coronary artery bypass graft
Correct Answer: B
Rationale: Back pain shortly after coronary angiography may indicate retroperitoneal bleeding, a life-threatening complication requiring immediate investigation. The other conditions are less acute or expected.
A client is seen in the clinic and determined to have a hydatidiform mole. Which diagnostic test can confirm the diagnosis of a hydatidiform mole?
- A. An ultrasound
- B. Alpha-fetoprotein
- C. Human chorionic gonadotrophin
- D. Lecithin sphingomyelin ratio
Correct Answer: A
Rationale: Ultrasound is the primary diagnostic tool for confirming a hydatidiform mole, showing a characteristic 'snowstorm' pattern. Elevated human chorionic gonadotropin supports the diagnosis but is not confirmatory alone.
A client expresses concern about facial appearance after surgery for excision of a melanoma on the side of the nose. What is the best response by the nurse?
- A. Have you shared your concerns with your health care provider (HCP)?
- B. If I were you, I would be more worried about whether the melanoma has spread.
- C. Scar tissue formation is part of the natural healing process. We will teach you how to care for your wound to minimize any complications.
- D. There is special make-up you can use to hide any facial scars left from the surgery.
Correct Answer: C
Rationale: This response addresses the client's concern about appearance by providing education on wound care to minimize scarring, promoting empowerment and trust. A deflects the concern without addressing it. B dismisses the client's feelings and focuses on an unrelated issue. D assumes scarring and offers a cosmetic solution prematurely, which may not address the client's emotional needs.
The nurse is planning a staff education program about intimate partner violence. Which of the following information should the nurse include? Select all that apply.
- A. Intimate partner violence is most common in high-income families.
- B. Intimate partner violence is rare in same-sex partnerships.
- C. The abusive partner often demonstrates jealousy and possessiveness.
- D. Victims may not leave due to financial concerns or fear of harm by the abuser.
- E. Violence against a female often intensifies during pregnancy.
Correct Answer: C,D,E
Rationale: Jealousy/possessiveness, barriers to leaving (financial/fear), and increased violence during pregnancy are accurate. Violence is not limited to high-income families and occurs in same-sex partnerships.